NPI | 1609434588 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011513) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 076070-23) |
Enumeration Date | 2019-06-05 |
Last Update Date | 2022-01-29 |